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Living with Bowel Control Problems

Living with a bowel control problem can be upsetting. You may feel ashamed and alone. There are steps you can take to manage your bowel control problem.

How do I cope with my bowel control problem?

Try these everyday tips:

  • Carry a bag with cleanup supplies and a change of clothes with you when leaving the house.
  • Find public restrooms before you need one.
  • Use the toilet before leaving home.
  • Wear disposable underwear or absorbent pads inserted in your underwear.
  • If you lose bowel control often, use a fecal deodorant—a pill that you chew or swallow to reduce the smell of stool and gas. These pills are available without a prescription. Your doctor can help you choose which type is best for you.

You should be aware that eating causes contractions in your large intestine that push stool towards your rectum. The rectum also contracts for 30 to 60 minutes after eating. Both of these events make it more likely that you will pass gas and have a bowel movement soon after eating. This activity may increase if you are anxious. You might want to avoid eating in restaurants or at social events, or you may want to take antidiarrheal medicines before eating in these situations.

You can also talk with your doctor and contact professional or patient-advocacy groups for information and support. See Links to Other Organizations.

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How are bowel control problems treated?

Treatment for bowel control problems may include one or more of the following:

  • eating, diet, and nutrition
  • medicines
  • bowel training
  • pelvic floor exercises and biofeedback
  • surgery
  • electrical stimulation

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Eating, Diet, and Nutrition

Changes in your diet that may improve your bowel control problem include

  • Eating the right amount of fiber. Fiber can help with diarrhea and constipation. Fiber is found in fruits, vegetables, whole grains, and beans. Fiber supplements sold in a pharmacy or health food store are another common source of fiber to treat bowel control problems. The Academy of Nutrition and Dietetics recommends getting 20 to 35 grams of fiber a day for adults and “age plus five” grams for children. A 7-year-old child, for example, should get “7 plus five,” or 12, grams of fiber a day. Fiber should be added to your diet slowly to avoid bloating.
  • Getting plenty to drink. Drinking eight 8-ounce glasses of liquid a day may help prevent constipation. Water is a good choice. You should avoid drinks with caffeine, alcohol, milk, or carbonation if they give you diarrhea.

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Medicines

If diarrhea is causing your bowel control problem, medicine may help. Your doctor may suggest using bulk laxatives to help you make more solid stools that are easier to control. Your doctor may also suggest antidiarrheal medicines that slow down your bowels and help control the problem.

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Bowel Training

Training yourself to have bowel movements at certain times during the day—such as after meals—may help. Developing a regular pattern may take a while, so don’t give up if it doesn’t work right away.

Pelvic Floor Exercises and Biofeedback

Exercises that strengthen your pelvic floor muscles can help with bowel control. To do pelvic floor exercises, you squeeze and relax these muscles 50 to 100 times a day. The trick is finding the right muscles to squeeze. Your doctor can help make sure you’re doing the exercises the right way. Biofeedback therapy may also help you learn to do the exercises correctly. Biofeedback therapy is painless and uses a machine to let you know when you are squeezing the right muscles. You practice what you learn at home. Success with pelvic floor exercises depends on what is causing your bowel control problem, how severe the problem is, and your motivation and ability to follow your doctor’s recommendations.

Surgery

Depending on the reason for your bowel control problem or how severe it is, your doctor may recommend surgery. Surgery options include

  • Sphincteroplasty, which involves sewing back together the separated ends of a sphincter muscle torn by childbirth or another injury and is the most common type of surgery for bowel control problems
  • Artificial anal sphincter, which is a procedure to place an inflatable cuff around your anus and implant a small pump beneath your skin to inflate or deflate the cuff
  • Nonabsorbable bulking agent, which is injected into the wall of your anus to bulk up the tissue around your anus, making the opening of your anus narrower so your sphincters are able to close better
  • Bowel diversion, which is an operation that reroutes the normal movement of stool out of the body when part of the bowel is removed; colostomy or ileostomy are the types of bowel diversion used to treat bowel control problems

Electrical Stimulation

Electrical stimulation involves placing wires in the sacral nerves to your anus and rectum and constantly stimulating the nerves with electrical pulses. Electrical stimulation is also called sacral nerve stimulation or neuromodulation. The sacral nerves connect to the part of your spine in the hip area. A battery-operated stimulator is placed under your skin. Based on your response, the doctor can adjust the amount of stimulation so it works best for you. You can turn the stimulator on or off at any time.

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What should I do about anal discomfort?

The skin around your anus is delicate and sensitive. Constipation and diarrhea or contact between skin and stool can cause pain or itching. Here are some things you can do to relieve discomfort:

  • Wash with water. Gently wash the area with water, but not soap, after a bowel movement. Soap can dry out and irritate your skin, and so can rubbing with dry toilet paper. Alcohol-free wipes are a better choice.
  • Air dry. Let the area air dry after washing. If you don’t have time, gently pat yourself dry with a clean cloth.
  • Use a moisture-barrier cream. Use a cream that contains ingredients such as dimethicone—a type of silicone—that form a barrier between your skin and stool. Clean and dry the area before you apply the cream. Ask your doctor what kind of cream to use.
  • Try nonmedicated powders. Plain talcum powder or cornstarch may help relieve pain or itching.
  • Use wicking pads or disposable underwear. If you use pads or disposable underwear worn in close contact with your skin, make sure they have a wicking layer. The wicking layer protects your skin by pulling moisture away from your skin and into the pad.
  • Wear clothes and underwear that allow air to flow. Tight clothes and plastic or rubber underwear that block air can make skin problems worse. Clothes and underwear that allow air to flow help keep skin dry.
  • Change soiled underwear as soon as you can.

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For more information about living with bowel control problems, see Resources.

Page last updated February 20, 2013


 

The Bowel Control Awareness Campaign is a service of the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health.

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